Tag Archive for: EAU 2016


EAU 2016 Congress Day 3

Das bringt mich weiter! While the sun was shining in Munich, the 3rd day of the 31st EAU Annual Congress continued with very well attended plenary and poster sessions. And that is no wonder because the EAU Scientific Committee had created such an attractive program, including amazing plenary sessions during the morning and a plethora of informative poster sessions in the afternoon.


Professor Hendrik Borgmann (@HendrikBorgmann) has already covered highlights of the opening days 1 and 2 of this year’s Congress in his BJUI blog. We will give you some highlights of Day 3 and highly recommend you to take a look on EAU congress website, Day 3, which has archived a huge amount of material to allow you to catch up on sessions you may have missed. Indeed, lots of webcasts are available!


We focused on non-oncology plenary morning sessions and oncology poster sessions afternoon. Here are some of our highlights:

SURGERY IN THE ELDERLY – As our urological patients become older and older, surgery for octogenarians, or even nonagenarians, is increasingly common. The morning session covered various aspects on diagnosis and treatment of benign prostatic hyperplasia and other urological conditions in the ageing patient.

Professor Cosimo De Nunzio began the morning with “Highlights” on lower urinary tract symptoms and prostatic disease presented during this year’s EAU congress. Also this year, as many as every third abstract was on either prostate cancer or prostatic hyperplasia.

EAU 3-1

Indeed, the plenary session on Day 3 also covered prostatic disease.

Professor Alexander Bachmann talked about surgery for BPO in the elderly. He pointed out that in elderly (high-risk) patients we do not need a complete anatomical tissue removal, we do not need a (very) long-term follow-up and that we do not need tissue for prostate cancer diagnosis. Instead, we need a safe and efficient operation with individual adaptation of the technique and preferably feasibility in an ambulatory setting or local anaesthesia.

EAU 3-2

Professor Bachmann further emphasized that it would be preferable if surgery for the elderly would be performed by experienced surgeons, and that age per se is not a reason to not operate. There are several new minimally invasive operations available, and especially for elderly less is often more.

HOW AND WHEN TO STOP ANTICOAGULATION – Managing perioperative thromboprophylaxis for patients who already receive anticoagulants remains a challenge. Associate professor Daniel Eberli and Professor Per Morten Sandset covered many of these aspects in their helpful presentations.

EAU 3-3

Dr. Eberli told us that bridging therapy (options for stopping or not stopping anticoagulation in the above figure) is eminence-based, as no papers exist showing benefits. He also presented data from the recent NEJM trial (BRIDGE study; see Table below), which showed that stopping anticoagulation without bridging was non-inferior to perioperative bridging for the prevention of arterial thromboembolism and decreased the risk of major bleeding.

EAU 3-4

Dr. Eberli gave us all a take home message to discuss and question our local bridging guidelines as new evidence is very likely not supporting them (concluding slide below).

EAU 3-5

Professor Sandset recommended that during the perioperative period only use aspirin in high-risk patients, that is, those with recent thrombotic event or extensive coronary heart disease. He also informed us that stopping antiplatelet therapy 5 days before surgery (figure below) is often the way to go, and agreed with Dr. Eberli regarding bridging therapy statements.

EAU 3-6

Professor Sandset also gave helpful information regarding use of direct oral anticoagulants (DOACs) in urological surgery:

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There were numerous poster sessions available on Day 3, as usual, many of them on prostate cancer. We have selected some of the highlight abstracts presented.

PROSTATE CANCER – On Day 3, prostate cancer presentations dominated once again in a number of poster, abstract and thematic sessions but also kidney, bladder, testicular and penile cancer sessions, which provided new interesting data.

Molecular markers, genomic profiling and individualized risk and treatment assessments were presented and discussed in poster session 58, and summarized by Stacy Loeb (@LoebStacy). Further advances in prostate cancer biomarkers in prostate cancer were presented in poster session 84. These new tools are moving from bench to bedside and urologists can hopefully incorporate these new tools to cancer care sooner rather than later.

In sessions on prostate cancer diagnostics, more advanced risk profiling tools were highlighted. For instance, STHLM3 test combines history of the patient, clinical parameters, biochemical markers and genetic markers. It was presented earlier in the congress and on Day 3 further health, economic and clinical evaluations were presented in Thematic session 12. It is one example of the tests showing promising results to potentially decrease the number of prostate biopsies needed. Other similar risk profiling tools were also presented during the congress. In addition to PSA only, evaluation of the smart use of already available clinical and biochemical parameters and the combination of genetic markers may bring individualized risk assessment of prostate cancer to the next level.

In poster session 62 on Day 3, diagnostic proceedings in prostate cancer with co-morbidity evaluation, biopsy strategies and MRI imaging were presented.  A combination of molecular markers and imaging may be the way to proceed in future. These aspects were covered nicely in Thematic session 12.

MRIs have been heavily integrated in prostate cancer diagnostics during recent years. Image guidance in prostate biopsies seem to be making a breakthrough in prostate cancer diagnostics. Targeted biopsies with cognitive or MRI-TRUS fusion imaging were shown to be the way to enhance the results and reliability of biopsies and cut down the number of biopsies. However, as biopsies are still needed in prostate cancer diagnostics, use of the pre-biopsy MRI protocols were suggested to be done only in clinical trial setting. Many aspects of MRI diagnostics of prostate cancer were elegantly summarized in Thematic session 11.

New sophisticated imaging technologies in addition to MRI were present in several sessions during the meeting. Diagnostic enhancement has been seen also in metastatic prostate cancer. PSMA-PET seems to be replacing choline-PET-TT in evaluation of relapsing and metastatic prostate cancer (e.g. Thematic session 10). More reliable diagnostics and imaging of prostate cancer are also enhancing the treatment decision and treatment choice of patients with local prostate cancer. Finding the right patients for the active surveillance protocols is also being helped with advanced diagnostics. Indeed, finding only patients who need treatment for prostate cancer should be the ultimate goal for enhanced diagnostics as discussed in poster sessions 66 and 75 on Day 3. There are also high expectations on focal therapy (e.g. poster session 66), which at the moment is still experimental but will likely be a real option for patients with low volume prostate cancer verified by imaging.

The role of quality of life evaluations and patient reported outcomes measured were heavily discussed during the congress in all treatment modalities of both local and advanced prostate cancer. Survivorship issues are an increasingly important issue when more effective treatments both in local and advanced prostate cancer are available.

In metastatic disease, the use of early chemotherapy in combination with hormonal treatment has been implemented very rapidly to clinical use after the results of the CHAARTED and STAMPEED studies. Further evaluation of early chemo in metastatic disease is still needed and the patient selection needs still clarification. Hormonal therapy still has a very marked role in metastatic prostate cancer and new advances can also be found in new strategies of using castration therapy as presented in poster session 67. Urologists should actively follow the changing landscape of the medical treatment of metastatic prostate cancer and be active in treatment planning and treatment of these patients. At the same time with poster session 62 novel drugs and new forms of isotope radiation therapy in castration resistant prostate cancer were discussed in poster session 61. These open new possibilities for potential treatments.

The clinical and scientific content of the program of the Day 3 was of a very high standard, and reflective of the breadth of contemporary research in many areas within urology. Besides this session, it was our pleasure to meet old and new urological friends worldwide. The annual EAU meeting remains a highly effective method of knowledge translation and provides the opportunity for collaboration between surgeon scientists and other researchers in the field. As always in big congresses, there are so many interesting sessions going on at the same time, that it is hard to pick up and follow everything you would like to. We hope that this report provides some memories and take home messages of the Day 3 to the readers of the BJUI and BJUI blogs.

We look forward to future BJUI and EAU happenings!


Kari Tikkinen

Urology resident, adjunct professor of clinical epidemiology

Helsinki University Hospital, Helsinki, Finland



Mika Matikainen

Chief of urology, adjunct professor of urology

Helsinki University Hospital, Helsinki, Finland



EAU 2016 Congress Days 1 & 2

Willkommen in München! I’m happy to give you some flavours of this year’s return of the EAU meeting to my home country after nine years of absence. Let’s start of with the first little episode that many of us might have encountered: Arriving at the congress centre, it took me only 1 minute to recognize that the EAU is always racing ahead: They placed the famous red London telephone box right in the centre of the entry hall. What a start! It created the scenery of joyful anticipation of EAU 2017 in England. Congress attendees were invited to take funny pictures. Great idea to do that on the first day of the congress rather than after many days of work and party. Not surprisingly the BJUI Board jumped in and seized this opportunity.

EAU-1-1Ben Challacombe and Matthew Bultitude
posing for EAU 17 in London.








But let’s get back to the present and to Munich’s highlights on Friday. The congress kicked off with the joint meetings of the EAU and various urological societies from around the globe. The EAU has started to reach out to urologists from all countries over the couple of years – one factor on their way to being currently recognized as the world’s leading association in our specialty. The joint sessions covered a colourful range of topics from urological oncology over men’s health to functional and reconstructive urology. Highlight of the day though was of course the opening ceremony on Friday night. I gave my best shot for BJUI’s best #selfie award when asking three beautiful violin artists to smile for the camera. I wasn’t successful, but it was fun anyhow.

🙂 You’ll find out the best #selfie winner later.

EAU-1-2@HendrikBorgmann at Opening Ceremony with Violin Artists






Still, the selfie experience made the girls feel so confident that they gave the audience a virtuoso, charmful atmospheric violin performance. EAU Secretary General Prof. Chapple gave out 13 awards for great achievements by pioneers in our field. Prof. Artibani received the Willy Gregoir Medal, Prof. Teillac the Frans Debruyne Life Time Achievement Award and Prof. Briganti the EAU Crystal Matula Award. Yet, the greatest honour was given to an absolute luminary in urology: When Michael Marberger received the EAU Honorary Member Award, standing ovations from the audience and an open-hearted applause created a goose bump atmosphere. There’s nothing more to say.

EAU-1-3Michael Marberger receiving the EAU Honorary Member Award








Waking up on Saturday after Friday nights activities – paying for it, as usual – drove me into the first plenary session: Evidence-based medicine vs. common practice / challenging the evidence. EAU Guidelines office chair James N’Dow and European School of Urology chair Joan Palou led the discussion, which used clinical cases to stimulate the debate between two opposing camps: pro vs. con for medical-expulsive therapy and personal experience vs. EAU guidelines for male incontinence after radical prostatectomy. The first plenary was rounded up by the AUA lecture by Abraham Morgentaler on a 40 years perspective on testosterone therapy.


EAU-1-4Lively discussions on the current state of evidence for medical expulsive therapy during the first plenary session

Munich’s conference centre made me cover some distance and burn some calories when rushing to the poster sessions. Funnily or annoyingly, depending on the point of view, a lot of poster presenters were fighting with rigid poster walls and poor needles. On top of that, scientific exchange was limited during the 20 minutes of poster viewing preceding the talks – shall we dedicate more time to talks instead?

EAU-1-5Poster presenters struggling to pin their research on stiff walls.


The EAU congress wasn’t all about the latest research though. Of course, education played a major role, which was reflected by over 70 hands-on training courses. You want to improve your surgical skills on adrenalectomy? No problem. Try out Green Light Laser Vaporisation and get advice from experts? Go ahead. Looking for advanced training on urethral stricture surgery? Sure! There were hands-on-training sessions for everybody.

EAU-1-6Practice, practice, practice. Trainers and trainees enjoying surgical simulation during hands-on-training course.

The congress wouldn’t have been the same without it’s indispensable elixir of life: LIVE SURGERY. The Urotechnology, Robotic Urology and Urolithiasis Sections shined with their latest advancements: 3D-HD laparoscopy, fluorescence partial nephrectomy, SPIES-assisted and NBI-assisted ureterorenoscopy for upper tract urothelial cancer – the spectacle went on and on. Interestingly, a working group from Italy took on the hot topic of ethics in live surgery for an important study: In their work “Live surgery: Harmful or helpful? Experience of the ‘Challenge in Laparoscopy and Robotics’ meeting” the authors retrospectively reviewed 197 live surgery cases. The authors found an acceptable overall complication rate of 11.6% according to Clavien Dindo classification. Over the course of time, the interest in live surgery seemed to remain alive, as shown by the high number of 539 participants per event. I think the study is very original and we can anticipate an interesting paper on this very soon.

Sunday morning was all about the Plenary Session on prostate cancer in the eURO Auditorium. Results of the TOOKAD® Phase III trial were highly anticipated. High noon was at 8AM when Marc Emberton presented the results of their study “TOOKAD Soluble ® versus active surveillance in men with low risk prostate cancer – a randomized phase 3 clinical trial”. 413 patients were randomized 1:1 to vascular-targeted photodynamic (VTP) therapy vs. active surveillance. Progression free survival rates were higher for VTP (28% of patients progressed) when compared to active surveillance (58% progressed; hazard ratio: 0.34; 95% confidence interval: 0.24-0.46; p<0.001). Also, fewer VTP treated men underwent radical therapy within 24-months: 6% vs. 29%, RR=0.20 [0.11-0.36].

EAU-1-7Results from the TOOKAD study

Discussant Declan Murphy congratulated the group for the well-designed study and asked 3 questions:

1.) Does this type of very low-risk prostate cancer need intervention?

2.) What is going on in the control arm?

3.) What is the impact of TOOKAD on future intervention?

The population from the PRIAS study was comparable to the presented study population. PRIAS showed that active surveillance can be pursued safely in very low-risk prostate cancer patients. Moreover, the control arm of the TOOKAD study had much worse outcomes for histological progression, negative biopsy and need for radical intervention when compared to the PRIAS population. Finally, salvage radical prostatectomy post-TOOKAD had notable morbidity and disappointing oncological outcomes in a small study of 19 patients, which differs from outcomes observed for radical prostatectomy after active surveillance.


EAU-1-8Take home messages from discussant Declan Murphy

After this strong opening, the prostate cancer fireworks continued with debates on the role for pre-biopsy MRI, timing of radiotherapy after radical prostatectomy and indications for chemotherapy in hormone-naïve prostate cancer.

On Sunday afternoon magic happened: the #EAU16 Twitter feed took the 10,000-tweet-hurdle for the first time in #EAU Twitter history: Congratulations and thanks to all contributors. More numbers needed? Up to 15 million impressions, 1,400 users and 115 tweets/hour show that the Twitter fan community is constantly growing. No one of us knows when the boom will slow down.

EAU-1-9Urologic Twitterati contributing to the #EAU16 Twitter feed.


Which content went viral though? See for yourself in the wordle I pulled from Tweetarchivist and the Retweet analysis from Twitonomy.

EAU-1-10Wordle showing the top words used in the #EAU16 Twitter feed.


EAU-1-11Most retweeted tweets during #EAU16.


Despite that, the social media highlight was yet to come: the famous BJUI SoMe awards! The urologic Twitterati gathered in the beautiful roof-top lounge in Munich city centre for the “cult awards” as Prokar Dasgupta (@prokarurol), BJUI Editor-in-chief, justifiably stated. We warmed up with wine or beer and felt the suspense increasing when everybody was waiting for Declan’s last-minute slide editing to the start the show. Prokar honoured the Twitter community for their huge engagement. While everybody was enjoying the show, we were coming closer to the most awaited prize: the @BJUIjournal best selfie award! Morgan Roupret (@MRoupret) and Angelika Cebulla (@AngelikaCebulla) were fighting hard for it, but it the end Maria Ribal (MariaJRibal) raced ahead and won the coveted award. But the show wasn’t over and the best was still to come in the final round: the @BJUIjournal Social Media Award 2016. Stacy Loeb (@LoebStacy) made a great proof-of-principle when initiating the #ILookLikeAUrologist campaign, which reached close to 1,000 tweets and was the well deserved award winner.

EAU-1-12Stacy Loeb receiving the prestigious BJUI Social Media Award 2016 from Prokar Dasgupta and Declan Murphy

For more details of the Award winners look out for Declan’s forthcoming blog, coming to this site soon.

Congratulations to all social media entrepreneurs! Stay tuned for EAU congress days 3 and 4! Peace, love and #urology!


Hendrik Borgmann, Urologist, Mainz/Vancouver



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